Telemedicine Lessons from Walmart & Texas Prisons - Dr. Glenn Hammack 9 feb2017

Lessons from WalMart and Texas Prisons

Telemedicine from Obamacare to Trumpcare

Guest: Dr. Glenn Hammack President and CEO NuPhysicia [email protected] diy.nuphysicia.com www.medicineatwork.net

2 © 2013 NuPhysicia, Inc. All rights reserved.

About Dr. Glenn Hammack

Dr. Glenn Hammack is founding President and CEO of NuPhysicia Inc., the private-equity-funded company providing advanced remote health services to markets across the U.S. and around the world. NuPhysicia has two medical service products: Medicine At Work®, the telemedicine alternative for on-site employee health, and InPlace Medical®, the health care solution for offshore, remote locations, and harsh environments globally. Additionally, NuPhysicia provides telemedicine services consulting and equipment to top-tier national hospitals and health systems through their patented DMS® solution. He received his OD Optometry degree with honors in 1984 from the Michigan College of Optometry at Ferris State University. In 1999 he completed a MSHI Master of Science in Health Informatics from the University of Alabama at Birmingham with a Telemedicine internship at Massachusetts General Hospital. He has contributed to several textbooks, has dozens of publications and abstracts in peer-reviewed literature, and is a frequent speaker and lecturer nationally and internationally.


TELEMEDICINE AT UTMB

1995



2000


Texas Telemedicine Program - Correctional Encounter Volume

Fiscal Year 2006 37,161 Anesthesiology 13 Dental 872 Dermatology 281 Diet / Nutrition - Education - Emergency Room 1,330 Internal MedicineAllergy 94 Asthma 4 Cardiology 1,789 Diabetes 4 Endocrinology 63 Gastroenterology 1,581 Geriatrics 1 Hematology 18 Hepatology 313 Infectious Diseases 4,437 Internal Medicine - General 375 Nephrology 74 Oncology - Pulmonology 95 Rheumatology 108 Subtotal - Internal Medicine 2,970 NeurologyEpilepsy - Neurology - General 722

Subtotal - Neurology 292 Obstetrics & GynecologyGenetics - OB-GYN - General 16 Subtotal - OB-GYN 6 Ophthalmology 1 Orthopaedics 2,858 Otolaryngology 302 Pediatrics - Pharmacy 569 Primary Care 6,043 Psychiatry 6,702 Radiology - Rehabilitation - Speech 6 SurgeryCT - Neurosurgery 106 Oral & Maxillofacial 28 Plastics 187 Surgery - General 751 Transplant - Urology 980 Vascular 101 Subtotal - Surgery 680 No Service Reported 6,337 TOTAL 37,161

Specialty

Specialty


2008

2016


Wal-mart Program Background

§  In May of 2008 NuPhysicia was approached to replace nurse-practitioner-staffed retail medical clinics at Houston area Walmart Supercenters with physician served telemedicine clinics.

§  The program needed to provide live physician interactive visits to six (6) locations around Houston suburbs. Medical assistants and paramedics assist the patient, and live video and supplemental examination tools support the physician examinations.

§  An EMR system provides communication, documentation, and prescriptions. §  The clinics take cash, check, or charge and do not file insurance. §  The program does not use grants or federal program funds in any form.


Map


Opening Day

Medical Assistant and Paramedic ready to go


Exam Room

Paramedic with EMR laptop ready to see patient


View Inside Store


Patient Demographics


Problems

ICD Descrption Count ICD Descrption Count 465.9 URI 233 110.0 Allopecia Areat 2 V70.0 Gen Phy Exam 190 250 DM 2,controlled 2 462 Acute Pharangit 118 386.30 Labyrinth 2

461.9 Acute Sinusitis 76 250.01 NIDDM 2 466.0 Acut Bronchitis 57 388.70 otalgia, unspec 2 401 Essential HTN 26 110.0 tinea capitus 2

372.0 Conjunct 18 708 urticarea 2 382.9 ASOM 17 789.0 Abdominal Pain 1 477.0 Allerg Rhinitis 15 919.0 abrasion 1 487.8 Flu 14 351.0 bell's palsy 1 V04.8 flu vaccine 10 949.0 Burn, unspecifi 1 380.1 Otitis Ext 10 726.33 Bursitis, elbow 1 782.1 rash, unspec 10 920 Contusion face 1 380.4 Cerum Imp 9 780.4 dizziness 1 790.6 Abnormal Lab 7 995.2 Drug Reaction 1 790.6 Hyperglycemia 7 530.81 Esopha Reflux 1 919.5 Insect Bite 6 V72.0 Exm Eyes/Vision 1 995.3 allergic reacti 5 379.91 Eye Pain 1 401.1 Benign Ess HTN 5 251.2 hypoglycemia 1 110.5 tinea corpus 5 272.0 Hyprchlstrlemia 1 684 Impetigo 3 785.6 Lymphaden 1

879.8 Laceration 3 723.1 Neck Pain 1 879.8 Punture wound 3 525.9 Pain, tooth 1 373.11 sty 3 110.3 Tinea Cruris 1

110.3 tinea curis 1 384.2 TM Perf 1 524.62 tmj 1


Clinic Operations Performance

Pts per Day

Rev per Pt

0.0

20.0

40.0

60.0

80.0

100.0

Aug-08 Sep-08

Oct-08 Nov-08

Dec-08 Jan-09

5.8 8.9 20.6 18.4

11.4 8.6

$77.05

$92.98

$64.23 $66.24 $72.88

$88.65

Pts per Day

Rev per Pt


We make telemedicine work.


Caring for Business

•  Staffed on-site clinic for workplaces

•  3-day or 5-day per week services

•  Paramedic on site •  MD services by advanced

video tools •  No startup costs •  No long-term contracts

www.medicineatwork.net


Scope of Services: 3 Key Areas

Convenience Care §  Coughs, Cold Symptoms, Flu §  Ear, Nose, And Throat Infections §  Skin Conditions And Rashes §  Muscle Aches and Pains §  Bladder Infections §  Red Eyes Including Pink Eye Wellbeing Support and Coaching Programs §  Blood Pressure, Cholesterol, Blood Sugar

Monitoring §  Stress Management §  Nutrition Counseling §  Weight Management §  Activity Counseling Occupational Medical Support §  DOT, Other Drug Screens §  Non-evidentiary Breath EtOH Testing §  Job Physicals, Pre-employment Physicals

www.medicineatwork.net


Consulting for Hospitals and

Health Systems

NuPhysicia was formed in 2007 to

leverage the success of telemedicine

programs developed at the University of

Texas Medical Branch (UTMB) in

Galveston, Texas, which proved to create

dramatic clinical efficiencies while

improving patient outcomes over large

populations over long periods of time.

NuPhysicia brings this expertise plus

commercial successes in global

telemedicine services to assist hospitals

and health care organizations across the

US. Leading national health care

accompanying executive summary

presentation for a strategic telemedicine

program plan. NuPhysicia will work

closely with your leadership, for optimized

data gathering and information sharing

meetings. A core team from your hospital

will be required to help facilitate this

process and secure the needed

information via data requests and

interviews.

The NuPhysicia team will use the data

obtained, and ongoing consultations

with your stakeholders as needs arise to

finalize the strategic telemedicine plan

document for you.

NuPhysicia Training – Clinical

Examination and Workflow

When you work with NuPhysicia, you are

partnering with the most experienced

telemedicine professionals in the industry. In

addition to assisting others create successful

telemedicine programs, we run our own

telemedicine service businesses in global offshore

remote medicine and US-based workplaces.

As such, we know how to DO telemedicine, not

just sell equipment. This means that we provide

the best in clinical telemedicine training, both

Clinical Telemedicine

Training

organizations have turned to NuPhysicia

when facing the challenge of creating

successful, scaled strategic telemedicine

programs.

With NuPhysicia’s recognized expertise

and experience, clients avoid having to

“start from scratch” and thus, will avoid

the common pitfalls and setbacks in

program development. NuPhysicia

provides a trusted and accountable

partner for your telemedicine successes.

NuPhysicia will provide its expertise and

knowledge, and with the input of your

stakeholders, will create a leadership-

focused written document and

Telehealth and Telemedicine Consulting

how to use the equipment and the process of seeing

patients.

Working with NuPhysicia, your patient-side clinicians

are trained by active telemedicine clinicians and

your physicians are trained by active telemedicine

physicians. This is unique in the industry. Your

telemedicine team will learn from individuals whom

have seen hundreds, if not thousands of patients.

Learning is always best when clinicians train clinicians.

On-site or remote options are available, as are one-

on-one live sessions or train-your-trainer programs.

Telemedicine Process

Management (TPM™) Software

Today’s organizations implementing

large-scale telemedicine programs

need more than a scheduler. They

need a complete telemedicine

process management software solution

– NuPhysicia’s TPM™

TPM™ is part of the Digital Medical

Services® or DMS® system, a US-

patented (US 7,912,733 B2) intellectual

property of the University of Texas and

is exclusively licensed to NuPhysicia. It

interfaces to one or more existing

electronic medical records,

automating telemedicine case ready-

status and intelligent notification to the

medical care team. Active monitoring

sends alerts on key events in the care

process.

With our decades-plus experience in building and

operating successful telemedicine programs,

clients choose us to procure and prepare

components as assembled packages for their

needs. NuPhysicia’s unique Integration and

Preparation™ service takes these components

and completes customized assembly with

improved cabling, strain relief, and upgraded

elements to make the system ready for daily

clinical care. Instead of boxes of gadgets and

cables, you get a patient-ready clinical

telemedicine package. Partnerships NuPhysicia helps clients design the most functional, cost effective systems for their application from a broad range of partnered technology providers. Clients are not locked in to a single resource or company product range.

How Does TPM™ work?

• Telemedicine endpoints report real-time

activity via proprietary messaging formats.

• The client EHR connects to +dms® via

secure API or uses +dms® EMRLite™

embedded application.

• The Telemedicine Process Manager –

operated as SaaS via secure cloud,

provides:

1. Provider Demand Awareness and

Patient Flow – +dms® secure web

messenger and virtual waiting room

browser pages.

2. Real Time Activity Alerts – Email or SMS

text – patient ready, patient waiting

too long, too many patients waiting,

more.

3. Analytics and Reporting – +dms®

secure web reports portal, detailed

patient flow data and summary

statistics.

Telemedicine Equipment Packages

TPM™ Software

Telemedicine Lessons from Walmart & Texas Prisons - Dr. Glenn Hammack 9 feb2017

Healthcare

Transcript of Telemedicine Lessons from Walmart & Texas Prisons - Dr. Glenn Hammack 9 feb2017